Prognostic impact of FDG-PET in surgically treated pathological stage I lung adenocarcinoma

Ann Thorac Cardiovasc Surg. 2014;20(3):185-91. doi: 10.5761/atcs.oa.12.02219. Epub 2013 Apr 20.

Abstract

Purpose: This retrospective study evaluated whether the maximum standardized uptake value (SUVmax) on 18F-deoxyglucose (FDG)-positron emission tomography (PET) could be used to predict the prognosis of patients with pathological stage I adenocarcinoma.

Methods: We analyzed 138 consecutive patients with pathological stage IA or IB lung adenocarcinoma except pure bronchioloalveolar carcinoma (BAC) who underwent preoperative FDG-PET imaging and curative resection from January 2005 to October 2010. We analyzed associations between disease-free survival (DFS) and clinicopathological factors.

Results: The 5-year DFS rate was 77.7%. Twenty two patients (15.9%) developed recurrence after surgery. Multivariate analysis identified SUVmax and lymphovascular (ly) involvement as the independent prognostic factors for recurrence (p = 0.0255 and p = 0.0333, respectively). We divided the patients into groups according to SUVmax and ly involvement. The 5-year DFS rate was 97.0% in patients with SUVmax ≤2.5 and without ly involvement, 100% with both SUVmax ≤2.5 and ly involvement, 70.2% with SUVmax >2.5 and without ly involvement, and 53.1% with both SUVmax >2.5 and ly involvement.

Conclusions: The results of this study suggest that SUVmax and ly involvement could be used to predict the prognosis of patients with pathological stage I adenocarcinoma. The combination of these prognostic factors could also identify high risk groups of recurrence.

Publication types

  • Evaluation Study

MeSH terms

  • Adenocarcinoma / diagnostic imaging*
  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery
  • Adenocarcinoma of Lung
  • Aged
  • Disease-Free Survival
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Kaplan-Meier Estimate
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery
  • Lymphatic Vessels / diagnostic imaging
  • Lymphatic Vessels / pathology
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Pneumonectomy
  • Positron-Emission Tomography*
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Radiopharmaceuticals*
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18